A Phase II Study of Efficacy and Safety of Induction Modified TPF (mTPF) Followed by Concurrent Chemoradiotherapy (CCRT) in Locally Advanced Squamous Cell Carcinoma of the Head and Neck (LASCCHN)
试验速览
- 阶段
- 2 期
- 状态
- 进行中(未招募)
- 入组人数
- 40
- 试验地点
- 3
- 主要终点
- objective response rate (ORR)
研究概览
简要总结
The purpose of the study is to evaluate the efficacy and safety of induction mTPF chemotherapy followed by concurrent chemoradiotherapy for locally advanced squamous cell carcinoma of the head and neck cancer
详细描述
The prognosis of patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN) is poor, therefore continuous research effort is being made in order to improve treatment efficacy. Standard treatment consists of concurrent chemoradiotherapy (CCRT) with cisplatin. In spite of many clinical trials and meta-analyses, the improvement of patient outcomes with the use of induction chemotherapy (IC) hasn´t been clearly demonstrated, partially due to the high toxicity of the standard TPF (docetaxel+cisplatin+fluorouracil) regimen used most frequently in this setting. Therefore, the aim of this study is to evaluate the outcomes of patients with LASCCHN treated with a less toxic induction mTPF regimen followed by CCRT.
The study will include patients with LASCCHN who - by the decision of the multidisciplinary team - have been assigned treatment with IC followed by CCRT. After being informed about the study objectives and potential risks, all patients giving written informed consent and meeting all the eligibility criteria will start the treatment. According to the study protocol, participants will receive 4 cycles of induction mTPF regimen repeated every 2 weeks followed by computed tomography (CT) response evaluation. 3-6 weeks after having completed the last cycle of mTPF, patients without disease progression will start CCRT with 2 cycles of cisplatin every 3 weeks. Twelve weeks after radiotherapy termination, a PET-CT scan will be performed in order to evaluate the treatment outcome.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •patients with locally advanced squamous cell carcinoma of the head and neck (LASCCHN): oral cavity, oropharynx, larynx, hypopharynx, and unknown primary
- •stage cT4 and/or cN2-N3, with no distant metastases (M0).
- •Eastern Cooperative Oncology Group Performance Status (ECOG PS) 0-2
- •initial clinical staging evaluated in:
- •CT scan or MRI of the neck and CT scan of the chest or
- •FDG18 PET TC
排除标准
- •patients with p16 positive oropharyngeal carcinoma cT0-T3 N2 M0 (stage II), unless extranodal tumor extension
- •contraindications for cisplatin administration: renal insufficiency (eGFR < 55ml/min), hearing loss, peripheral neuropathy
- •dysphagia G>2 with no percutaneous gastrostomy
- •the presence of distant metastasis (M1)
研究组 & 干预措施
induction mTPF
- 4 CYCLES OF INDUCTION mTPF: Docetaxel 40 mg/m2 iv day 1, Cisplatin 40 mg/m2 iv day 1, Leucovorin 400 mg/m2 iv followed by Fluorouracil (5FU) bolus 400 mg/m2 iv day 1, 5FU 1000 mg/m2 iv day 1-2, q2w. Primary neutropenic fever prophylaxis with GCSFs x 3 days
- CONCURRENT CHEMORADIOTHERAPY WITH 2 CYCLES OF CISPLATIN 100mg/m2 iv q3w
干预措施: modified TPF (Drug)
induction mTPF
- 4 CYCLES OF INDUCTION mTPF: Docetaxel 40 mg/m2 iv day 1, Cisplatin 40 mg/m2 iv day 1, Leucovorin 400 mg/m2 iv followed by Fluorouracil (5FU) bolus 400 mg/m2 iv day 1, 5FU 1000 mg/m2 iv day 1-2, q2w. Primary neutropenic fever prophylaxis with GCSFs x 3 days
- CONCURRENT CHEMORADIOTHERAPY WITH 2 CYCLES OF CISPLATIN 100mg/m2 iv q3w
干预措施: Quality of life assessment (QoL) (Other)
结局指标
主要结局
objective response rate (ORR)
时间窗: 12 weeks after radiotherapy termination
percentage of partial and complete response rates (RR)
次要结局
- 24 month progression free survival (PFS)(2 years)
- 24 month overall survival (OS)(2 years)
- toxicity of induction mTPF(up to 10 weeks)
- toxicity of concurrent chemoradiotherapy (CCRT)(through study completion, an average of 2 years)
- EORTC Head and Neck Cancer specific module (EORTC QLQ-H&N35)(9 months)
- EORTC Core Quality of Life questionnaire (EORTC QLQ-C30)(9 months)
研究者
Sebastian Ochenduszko
Attending Physician
Hospital Universitario Doctor Peset
